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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364804984
Report Date: 06/18/2021
Date Signed: 06/18/2021 01:05:38 PM

Document Has Been Signed on 06/18/2021 01:05 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364804984
ADMINISTRATOR:JULIE ZONEFACILITY TYPE:
830
ADDRESS:13815 PEYTON DRTELEPHONE:
(909) 464-2255
CITY:CHINO HILLSSTATE: CAZIP CODE:
91709
CAPACITY: 36TOTAL ENROLLED CHILDREN: 0CENSUS: 7DATE:
06/18/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Julie ZoneTIME COMPLETED:
01:15 PM
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A required – 1 year inspection was conducted as part of a compliance review. Licensing Program Analysts (LPAs) Kim Leung and Corey Hall toured the center, inside and out. The following was observed:
· The licensee is asked to update the following documents, if applicable, and submit to licensing within 30 days:
1. LIC 500 Personnel Report
2. LIC 610 Emergency & Disaster Plan (only if changes have been made)
3. Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made)
4. LIC 309 Administrative Organization (only if changes have been made)
· The following items have been posted and are updated where necessary:
- License
- Emergency Disaster Plan (LIC610)
- Parent’s Rights Poster (PUB393)
- Personal Rights (LIC613A)
- Child Car Seat Law
- Menu
· The facility is operating within the terms of the license
· Ratios were met during this inspection
· Appropriate supervision was provided during this inspection
· Classrooms are equipped with age appropriate furniture and equipment in good condition
· No weapons stored at the facility as stated by director Julie Zone
· There are no accessible bodies of water present. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Medications are stored inaccessible to children
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Kim Leung
LICENSING EVALUATOR SIGNATURE: DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/18/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/18/2021 01:05 PM - It Cannot Be Edited


Created By: Kim Leung On 06/18/2021 at 11:31 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364804984

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/18/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/18/2021
Section Cited
CCR
101170(e)2

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Criminal Record Clearance. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working...request a transfer of a criminal record clearance as specified in Section 101170(f). This requirement was not met as evidence by: LPAs observed Staff 1 supervising children during the inspection.
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Staff 1's criminal record clearances are associated to another Kindercare facility at another location owned by the same licensee. Deficiency was corrected during inspection when facility staff associated Staff 1 in Guardian, the Licensing criminal record clearance system.
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There is no verification to support that the staff member's criminal record clearances are associated or have ever been associated to this facility. Director stated that staff 1 has been working at this facility since February 2021. Failure to associate criminal record clearances to the license presents potential risks to the children's safety.
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Type B
06/22/2021
Section Cited
CCR101429(a)(2)(B)

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Responsibility for Providing Care and Supervision for Infants. Sleeping infant(s) shall be directly observed by sight and sound at all times. Staff shall physically check on sleeping infant(s) every 15 minutes and document the following: 1. Labored breathing. 2. Signs of distress, which includes but is not limited to flushed skin
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That presented potential risks to the infants' health and safety. Director Julie Zone agreed to provide training to staff and ensure sleeping infants are physically checked every 15 minutes. Director agreed to ensure that all observations be documented.
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color, increase in body temperature and restlessness. This requirement was not met as evidenced by: Director Julie Zone stated that there were not nap time observation log maintained for the toddler class. Children attending the toddler class are 14 months of ages and older.
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Proof of training and observation log for this date 6/18/2021 through 6/22/2021 will be submitted to Licensing as evidence of correction.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Aaron Ross
LICENSING EVALUATOR NAME:Kim Leung
LICENSING EVALUATOR SIGNATURE:
DATE: 06/18/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/18/2021


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364804984
VISIT DATE: 06/18/2021
NARRATIVE
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· Hazards are stored where inaccessible to children which include: Disinfectants, cleaning solutions and other items that are dangerous
· Poisons and toxins are locked
· All floors are clean and safe
· Activity areas are physically separated from all other components at this center
· Napping equipment is sufficient for capacity and meets licensing requirements.
· Changing tables were observed to be safe, sanitary and are located within the arm's reach of a sink with running water
· Outdoor play area is physically separated by appropriate fencing and free of hazards
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· Kitchen is clean, free of litter, rubbish and free of rodents and other vermin. Infant food preparation area is clean and free of vermin
· Food is stored appropriately and protected from contamination
· LPA reviewed the requirements regarding storage containers for solid waste. All trash bins must have tight-fitting covers that are kept on, and in good repair
· Menus are posted at least one week in advance in the hallway
· Drinking water are readily available both indoors and out and provided by use of pitchers of water and disposable cups
· The areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with woodchips that absorb falls
· Sign in/Sign out record was reviewed and meets regulation requirements
· A Staff member is present with current Pediatric CPR/First Aid which expires in January 2022
· Opening and closing staff member’s CPR/First Aid expires in January 2022 (Cassandra Lazalde who opens and Julie Zone who closes)
· Infant needs and services plans, Individual Sleeping Plans and nap time observation logs were reviewed. Director Julie Zone stated that there were not nap time observation log maintained for the toddler class. Children attending the toddler class are 14 months of ages and older.
· The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov
· A sample of children's records were reviewed. The records contain Identification and Emergency Information. A sample of staff records were reviewed. The records contain health screening and verifications of educational qualifications.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Kim Leung
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364804984
VISIT DATE: 06/18/2021
NARRATIVE
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· Documentation of fire & earthquake drills were reviewed. Last drill was conducted on 5/19/2021.
· A review of staff records on 6/18/2021 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions except for Staff 1 who has been working for the facility for several months but not associated to the facility.
The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov
· Facility is providing IMS This facility provides Incidental Medical Services – IMS. Written plan of operation including IMS is on file. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) / (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.
· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Risk-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

See LIC 809D for deficiencies cited.

Licensing updates were provided to the director on Facility Evaluation Report dated 6/18/2021 for the preschool program, facility #364804982.

An exit interview was conducted and during the interview, director Julie Zone confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address. A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS. A copy of this report was provided to the facility.
Appeal rights were provide and discussed. This report must be available for review, upon request, for the next 3 years.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Kim Leung
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
LIC809 (FAS) - (06/04)
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